Gilbert S, McBurney E
Dermatology and Laser Center Northwest, 3614 Meridian, Suite 200, Bellingham, Washington, USA.
Dermatol Surg. 2000 Jan;26(1):50-4. doi: 10.1046/j.1524-4725.2000.99166.x.
Reactivation of herpes simplex virus-1 (HSV-1) after facial resurfacing has led to severe outbreaks, delayed reepitheliazation, and scarring. Current recommendations regarding the dosing of antivirals used prophylactically are based mostly on anecdotal experience. No studies have addressed the question of when such antiviral prophylaxis should begin.
The purpose of this study was to compare the efficacy of valacyclovir used as an antiviral prophylaxis when started the morning before versus the morning of facial resurfacing procedures.
Eighty-four patients who presented for facial resurfacing were enrolled. Resurfacing was performed using laser (CO2, Er:YAG), chemical peeling, dermabrasion/dermasanding, or some combination of these techniques. Patients were randomly assigned to start valacyclovir 500 mg twice daily either the morning before or the morning of the procedure. Viral cultures were performed at baseline on all patients, at any sign of infection, and at the end of the 14-day treatment period. All patients were followed for 21 days postoperatively.
Valacyclovir was 100% effective in the prevention of HSV reactivation in both regimens with no adverse effects reported.
This study demonstrates the efficacy of valacyclovir as a preventive agent against HSV outbreaks following facial resurfacing whether started the day before or the day of surgery.
面部皮肤磨削术后单纯疱疹病毒1型（HSV-1）再激活可导致严重发作、上皮再形成延迟和瘢痕形成。目前关于预防性使用抗病毒药物剂量的建议大多基于轶事经验。尚无研究探讨这种抗病毒预防应何时开始的问题。
本研究的目的是比较在面部皮肤磨削术前一天上午与手术当天上午开始使用伐昔洛韦作为抗病毒预防的疗效。
纳入84例接受面部皮肤磨削术的患者。使用激光（二氧化碳、铒：钇铝石榴石）、化学剥脱、磨皮/磨沙或这些技术的某种组合进行皮肤磨削。患者被随机分配在手术前一天上午或手术当天上午开始每天两次服用500mg伐昔洛韦。在基线时对所有患者、出现任何感染迹象时以及14天治疗期结束时进行病毒培养。所有患者术后随访21天。
两种方案中伐昔洛韦预防HSV再激活的有效率均为100%，且未报告不良反应。
本研究证明了伐昔洛韦作为预防面部皮肤磨削术后HSV发作的预防剂的疗效，无论在手术前一天还是手术当天开始使用。
